Pneumonitis of Post Traumatic and Septic States: Identification of Causative Agents

摘要

In a continuing effort to isolate the circulating factor or factors responsible for the development of adult respiratory distress syndrome after trauma or the onset of sepsis, the plasmas of 40 patients were tested in a perfused rabbit lung bioassay. Of these, plasma from 60% of the post traumatic patients and 89% of the septic patients caused edema and an elevation of pulmonary artery pressure in the test lung. Of 12 pigs with peritonitis induced by cecal ligation, 6 gave evidence of a pulmonary shunt by the presence of hypoxemia. Plasma from the same animals were positive by bioassay. The administration of heparin or trasylol to the animals caused the test to become negative. The presence of one or more abnormal peptides of molecular weight 4000-6000 in the plasma of septic patients was demonstrated by Amicon filtration, column chromatography, and thin layer chromatography. A rabbit antibody was made to this fraction of plasma from septic patients which only reacted with septic plasma after absorption with normal plasma. Heating the plasma to 56 C inactivated the response. By immunoelectrophoresis both the antibody and rabbit anti C3 gave similar responses.